Abstract
BackgroundThree-quarters of sub-Saharan Africa’s urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana’s rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS.MethodsThe study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software.ResultsFindings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs’ apprehensions with regards to furthering their education and progression in their careers were key concerns raised.ConclusionThe establishment of the CHPS concept in the urban environment albeit challenging has been fraught with several opportunities to introduce innovations which tailor the rural milestones to meet urban needs. Modifications such as adjusting timing of home visits and renting accommodation in the communities for the CHOs have been beneficial to the programme.
Highlights
Three-quarters of sub-Saharan Africa’s urban population currently live under slum conditions making them susceptible to ill health and diseases
The urban poor have become a group much afflicted by complex health problems associated with the living conditions in their communities, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility [3, 4]
During the interviews, various aspects of the implementation of the Community-Based Health Planning and Service (CHPS) programme in urban areas were highlighted. These include the health workers’ knowledge about the urban CHPS concept, the services offered by Community Health Officer (CHO) during home visits, the community acceptance of the urban CHPS concept, the welfare of the Attended 2 years of Community Health Training School
Summary
Three-quarters of sub-Saharan Africa’s urban population currently live under slum conditions making them susceptible to ill health and diseases. Similar to other developing countries, Ghana’s fastest population growth takes place in urban areas which leads to the formation of informal peri-urban settlements and slum communities that lack basic facilities such as sanitation, clean water sources, or healthcare facilities. In these communities, a health crisis has emerged, and in addition to poor referral systems for maternal and child health emergencies, there is an increase in infant and child mortality rates, rapid spread of HIV and other STDs, unwanted teenage pregnancy and unsafe abortions [1]. The low socio-economic status and poor education of this group makes it imperative for service delivery to be provided at household and community levels
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